1. Technical Field
The present disclosure is directed to a system/assembly for facilitating introduction and/or positioning of a surgical stapler at or to a desired anatomical location. More particularly, the present disclosure is directed to an introducer system/assembly that is adapted to be detachably mounted with respect to a surgical stapler, e.g., an end-to-end or end-to-side anastomotic stapler.
2. Background Art
Wound closure techniques include the use of surgical staplers and clip appliers in many clinical applications. Surgical staplers and clip appliers take many forms and are adapted for use in various modalities. Thus, for example, certain staplers are specifically designed for application of skin staples, while others are adapted for use in internal procedures. Indeed, surgical staplers and clip appliers have been developed and are employed in both “open” and “minimally invasive” surgical procedures.
One particular form of surgical stapler having a specialized design and specialized uses is a circular stapler for use in performing end-to-end and end-to-side anastomotic procedures, e.g., the EEA™ line of staplers (Covidien, Inc., Mansfield, Mass.). The noted circular staplers generally take the form of a tubular instrument that defines a tubular shaft at a distal end thereof. A disposable cartridge is generally adapted to be mounted with respect to tubular shaft, such cartridge containing two or more circular rows of staggered staples, pushers for driving the staples from the cartridge and a circular knife within the inner ring of staples. An anvil assembly is adapted to mount with respect to a distally extending rod such that, when the anvil assembly is brought into close juxtaposition with the staple cartridge, the staples may be discharged from the cartridge and formed against anvil pockets defined in the anvil assembly. In addition, the anvil assembly also generally includes a plastic ring into which the circular knife is driven during the stapling operation. A control mechanism is provided at the proximal end of the surgical stapler to control relative movement between the staple cartridge and the anvil assembly. Once approximated, an actuating mechanism at the proximal end of the surgical stapler is employed to deliver staples into tissue and advance the circular knife into the plastic ring, thereby forming an anastomotic junction.
Circular staplers of the type described above are generally employed in esophageal and rectal procedures, although the staplers have utility throughout the gastrointestinal tract. For example, in bowel surgeries, purse-stringed bowel segments to be anastomosed are passed over the anvil assembly—which is typically dome-shaped—and the staple cartridge, respectively, and the purse-strings tightened around the central shaft. The anvil assembly and staple cartridge are then approximated and upon actuation of the actuating mechanism, an instantaneous, minimally-inverting, end-to-end or end-to-side anastomosis is effectuated. The circular stapler may be introduced and positioned through a natural orifice, e.g., the anus (e.g., a low anterior resection of the rectum) or the mouth (e.g., high esophago-gastric anastomosis). Alternatively, the circular stapler can be introduced through an opening formed during a procedure, e.g., in the stomach for esophagogastrostomy, in the small bowel for esophagojejunostomy, the terminal ileum for esophagocecostomy, and the like.
Of note, introduction and positioning of a circular stapler can be difficult in practice due to the physical structures associated with the distal end of the stapler. In particular, the stapler cartridge generally defines a substantially flat surface that is to be advanced through the intestinal tract or other anatomical lumen. Indeed, challenges exist in introducing a substantially flat surface into an orifice and thereafter advancing such flat surface through the lumen, e.g., up into the rectum, potentially encountering redundancies to the colon, redundant mucosa and/or prominent valves. Difficulties in introducing a surgical stapler and/or positioning the surgical stapler in a desired anatomical location can inhibit its successful use.
Prior art efforts to address the above-noted issues have been less than satisfactory. Thus, for example, U.S. Pat. No. 5,404,870 to Brinkerhoff et al., U.S. Pat. No. 5,836,503 to Ehrenfels et al., and U.S. Patent Publication No. 2005/0165438 to Gritsus disclose devices and/or geometries that are intended to facilitate introduction and/or positioning of surgical staplers. Additional patent-related publications of background interest include U.S. Pat. Nos. 7,318,830; 5,355,897; 5,314,436; 4,471,782; 3,672,367; and 2,007,626, as well as U.S. Patent Publication No. 2005/0236459.
However, despite efforts to date, a need remains for introducer systems and assemblies that facilitate introduction and positioning of a surgical stapler relative to a desired anatomical location. A need further remains for introducer systems and assemblies that are adapted for easy and reliable detachment from the surgical stapler once its introduction and/or positioning functionalities are complete. These and other needs are satisfied by the introducer systems and assemblies disclosed herein.